I love this story:
A sect decided their god was going to end the world. A flood, they said, would engulf us all. On the appointed day they met and waited. Nothing happened. It didn't even rain. They woke up the next morning and everything had trundled on, just the same.
Did the sect disband? Give up? No, they consoled themselves with the idea that recognising their faithfulness, their god had relented and it was their commitment that had saved the world.
Barmy? Actually, no. It happened, in the US, in the 50's and was the source of a study by psychologist Leon Festinger. He infiltrated the group and reported events. He went on to describe a phenomenon we know, today, as 'cognitive dissonance' (CD).
CD, in English; the mess we get into when we are asked to hold two contradictory beliefs or values at the same time. In our world it explains a lot. Last week there were four examples.
First... Listen to the Tinker-Man, he sincerely believes his health policies are working, voters reassured and given a hiccup here and there, everything is jogging along nicely and under control.
The reality; 2/3rds of Trusts are 'unsafe', most of them can't balance their books, 33 don't have a permenant chief executive. No one has enough staff to be safe and in the first three months of the year we are nearly a �1bn out. Oh, and the junior doctors dispute...
Cognitive dissonance. The solution? A reshuffle.
Second... The CQC; they trundle about, costing the taxpayer �200m or more, telling us the same things. They press on. We've had; collegiate, light touch, deep dive and intelligent inspection; doing it for 16 years. If it was going to work it would have done so by now. Three in four hospitals 'failing'. Their annual report is a catalogue of not making a difference, presented as a triumph. Frankly, it is, as the BBC infers, a misleading, muddled mess and text-book CD.
The solution; bring back community health councils.
Third... Whistle-blowers; events that rip people's lives apart. Most of the time the issues are not worth the argument and dealt with promptly, can easily be fixed. What gets in the way? Cognitive Dissonance; bosses that cannot get their heads around the fact that their organisations are not as good as they think they are.
Last Friday I sat through a miserable morning at a conference where whistle-blowers recited their stories; bullying, neglect, obfuscation. Horrible. Cognitive Dissonance prevents their resolution. The belief the organisation is right when all the evidence points to the fact it is wrong.
The solution? An amnesty. Stop all proceedings on both sides. If whistle-blowers want to come back let the NHS find a space for them. Tell the lawyers to pack their bags. Drop all prosecutions, proceedings and hearings.
No blame, no fault, no culpability. Close the files. Draw a line, move on. Let the NHS start again and become the employer of choice and an exemplar of good practice we know it can be.
Forth... Safe staffing; actually, this is the odd-man out. This is more double-think than cognitive dissonance. Last week we stopped pretending there's enough money and nurses for Trusts to get near fulfilling NICE's potty 'wait for a problem and wave a red flag' guidance.
The new double-think is Trusts Boards will run safe without more money or nurses and rules. Pressured to balance the books the belief is they won't end up in the same mess as Mid-Staffs.
Perhaps there is number five... Nearer to home; we shouldn't eat ice cream, smoke and take more exercise... but calcium in dairy is good for me, loads of folk smoke and live to a ripe old age and people who exercise get injured. CD; the lies we tell ourselves!
Overcoming cognitive dissonance is, in many ways, like growing up (just like the Trust Boards are going to have to); looking in the mirror, confronting painful reality.
The truth won't go away by wrapping our minds around issues and making them fit our version of reality. We must unwrap them, meet them head on and deal with the ugliness of the actuality.
Question; if you call a tail, a leg, how many legs does a cat have?
Answer; four. The reality is; it doesn't matter what you call it, a tail will never be a leg.
